When the [woman] arrived at the hospital with severe abdominal pains, a nurse didn’t consider it an emergency, noting that [she] was obese and had stopped taking blood pressure medicines. In reality, [she] was pregnant — a transgender man in labor that was about to end in a stillbirth.

The tragic case, described in Wednesday’s New England Journal of Medicine, points to larger issues about assigning labels or making assumptions in a society increasingly confronting gender variations in sports, entertainment and government. In medicine, there’s a similar danger of missing diseases such as sickle cell and cystic fibrosis that largely affect specific racial groups, the authors write. . .

Transgender men, who are considered female at birth but who identify as male, may or may not be using masculinizing hormones or have had surgical alterations, such as womb removal.

The 32-year-old patient told the nurse [she] was transgender when [she] arrived at the emergency room and [her[ electronic medical record listed [her] as male. [She] hadn’t had a period in several years and had been taking testosterone, a hormone that has masculinizing effects and can decrease ovulation and menstruation. But [she] quit taking the hormone and blood pressure medication after he lost insurance. . .

Several hours later, a doctor evaluated [her] and the hospital test confirmed pregnancy. An ultrasound showed unclear signs of fetal heart activity, and an exam revealed that part of the umbilical cord had slipped into the birth canal. Doctors prepared to do an emergency cesarean delivery, but in the operating room no fetal heartbeat was heard. Moments later, the [woman] delivered a stillborn baby. (Read more from “A Pregnant ‘Man’s’ Medical Emergency Proves a HUGE ISSUE with Transgenderism” HERE)